Document Detail

Failure of primary anterior cruciate ligament surgery using anterior tibialis allograft.
MedLine Citation:
PMID:  17478276     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The purpose of this study was to evaluate the outcome of anterior cruciate ligament (ACL) reconstruction via anterior tibialis tendon allograft. METHODS: We performed a retrospective review of 125 consecutive patients who underwent ACL reconstruction via an anterior tibialis tendon allograft. Of these patients, 69 were available for follow-up at a mean of 55 months (range, 42 to 74 months); their mean age was 31.7 years (range, 19 to 69 years). Clinical evaluation consisted of the Lysholm knee score, activity level assessment, and International Knee Documentation Committee assessment. RESULTS: Of the 69 patients, 16 (23.1%) required revision ACL reconstruction for graft failure. In addition, 26 patients (37.7%) required repeat surgery, including 16 revision ACL reconstructions, 9 arthroscopic meniscal surgeries, and 1 total knee arthroplasty. The mean age of those patients in whom failure occurred was 22.8 years compared with 34 years in those in whom failure did not occur (P = .0039). The failure/reoperation rate of those aged 25 years or under was 55% (17/31), as compared with 24% (9/38) in those aged over 25 years. The mean Lysholm knee score was 85.6 (range, 15 to 100), and the mean activity score was 4.36 (range, 0 to 9). Of the 52 patients who did not require revision ACL surgery, 86.2% rated their knee as normal or nearly normal. CONCLUSIONS: A reoperation rate of 38% after primary ACL surgery is high. We do not recommend the use of anterior tibialis allograft in young patients (aged < or =25 years) or those who participate frequently in level I ACL-dependent sports. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Manuj C Singhal; James R Gardiner; Darren L Johnson
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  23     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-06-14     Revised Date:  2007-09-28    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-75     Citation Subset:  IM    
University of Kentucky, Lexington, Kentucky, USA.
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MeSH Terms
Age Factors
Anterior Cruciate Ligament / injuries,  surgery*
Arthroscopy / methods,  statistics & numerical data*
Follow-Up Studies
Knee Injuries / surgery*
Middle Aged
Recovery of Function
Reoperation / statistics & numerical data
Retrospective Studies
Treatment Failure
Comment In:
Arthroscopy. 2007 Sep;23(9):1026   [PMID:  17868847 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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